What is incapacity for work?
Incapacity for work (AU) exists when an employee can no longer perform their last activity due to illness, or only at the risk of worsening their condition. The benchmark is the specific activity, not the profession in general.
Sick notes and the electronic AU (eAU)
Incapacity is determined by a doctor. Since 2023 reporting uses the electronic sick note (eAU): the practice transmits the data directly to the statutory health fund, and the employer retrieves it digitally. This applies to employees covered by statutory health insurance; privately insured employees still receive a paper certificate.
Notification and proof duties
- Notification: employees must inform the employer of the incapacity and its expected duration immediately.
- Proof: if the AU lasts more than three calendar days, it must be established by a doctor by the next working day (§ 5 (1) sentence 2 EFZG); the employer may require this earlier. If the fourth day falls on a weekend, the deadline moves to the next working day.
- No duty to submit for statutorily insured employees: they only have to have the incapacity established and be handed a certificate; the employer retrieves the eAU from the health fund (§ 5 (1a) sentence 1 EFZG). Privately insured employees and mini-jobbers in private households still have to submit one.
Duration, continued pay and sick pay
The employer continues full pay for up to six weeks (§ 3 (1) EFZG). Afterwards the health fund pays sick pay, for the same illness up to 78 weeks within three years (§ 48 (1) SGB V). After longer incapacity a phased reintegration often follows, and from more than six weeks of AU within one year the employer must offer a BEM (§ 167 (2) SGB IX).
Leading causes – and the prevention lever
While respiratory illnesses account for the most AU cases at 66.5 cases per 100 insured, mental illnesses cause the longest absence per case at 32.9 days (DAK Gesundheitsreport 2025, data year 2024, reference: DAK members, not all employed people). This is the biggest lever for employers: the psychological risk assessment under §5 ArbSchG systematically uncovers psychological stressors before they cause long absences. Learn more →